January 30, 2008

Ever since the publication of the long-delayed results of the Zetia/Vytorin trial a few weeks ago, the study which raised serious questions about whether lowering LDL does anything to prevent heart attack death, the media have been full of M.D.s pontificating on the importance of lowering LDL and the wonderfulness of statin drugs.

I've heard them on NPR. I've seen them on my local TV news channel. Clearly the drug industry spinmeisters have been hard at work sending out press releases.

On the local news channel tonight, a doctor insisted that you could lower cholesterol by not eating fat and not eating cholesterol, but if that didn't work, you should take a statin drug because statins were "proven" to prevent heart disease in people with "risk factors."

Those of you who are educated about nutrition know that the first two statements are just plain wrong and that the third statement is only true if by "risk factors" you mean, "being a male, under 65 and having already had a heart attack." The sample patient in the TV news story was a young, thin, fit man, shown exercising at the gym, who said he had just been told he had high cholesterol. The point of the brief news story seemed to be that people like him needed to take statins.

On the NPR health show, the featured doctor went so far as to say he thought just about everyone should be on statins starting in their 20s.

As you may know, the American Heart Association (a wholly owned subsidiary of Big Pharma and the Cereal Industry) rushed into print immediately after the release of the Zetia/Vytorin results telling a New York Times reporter that people should continue taking these drugs even though this major study make it clear that they are at best ineffectual and at worse may make arteries clog faster.

A follow up article in the New York Times pointed out that the AHA failed to disclose to the reporter the many millions of dollars it gets from makers of these drugs. The article also pointed that the AHA's web site links to a page advertising Vytorin using what looks like an informational link purporting to be about the sources of cholesterol. Clearly the American Heart Association is highly influenced by the people who give them money.

I expect to see a lot more of this kind of story in the media in days to come. You will too. When you do, take the time to contact the media outlet and explain to them how disappointed you were that they presented a drug company press release as if it were a news story rather than providing a balanced story investigating the growing weight of evidence casting doubt on the efficacy of statins for anyone who is not a male under 65 with a previous heart attack.

Today's variant on the spin is a AHA "wear red" assault on women's health, which urges women to get their cholesterol measured--and points them to a web site recommending "healthy" low fat/high carb diets. The photo on the AHA sponsored web site is of a big slice of pizza made with low fat cheese.

Did ANYONE reporting on the health industry notice the huge and very well conducted Women's Health Initiative study (WHI) proved conclusively that low fat dieting DOES NOT HAVE ANY EFFECT ON WOMEN'S HEART DISEASE?

Obviously not. Junk food empires Campbells and Kelloggs are listed as sponsors of this AHA program but the top sponsor is Merck, makers of Vytorin and Zocor.

Where can I get study information on Lipitor. My Endo just tried to tell me that I NEEDED it and I told her the stuff was bad for you and that it's been determined that it's really only good for guys under 65 that have had a heart attack. She argued that it was not true and especially perfect for me as a 45 yr old with diabetes, that hasn't had a heart attack and only has elevated LDL. I'd like to bring her something in writing for our next visit.

I told her I wanted to get my BS numbers down and then we could talk about Lipitor at my next appt after my next set of labs. Told her I prefer to keep my memory and money and try to get my LDL numbers down in some other way.

Thanks to you and Dr. Bernstein I was able to hold an educated diabetes conversation with her that she really didn't expect, but thankfully really did appreciate. ( she even tested me on a couple of the diabetes meds, what they did, how they worked and where Byetta orginated) She was impressed with my knowledge(not that I'm a genius), testing and records and therefore respected my wishes and thoughts.

The problem with so many of the studies touted as proving statins are effective is that you have to comb through the actual study with some knowledge of statistics to see how they've played games with the results to come up with strong conclusions from weak data.

Most M.D.s are uneducated about statistics and they never look at the actual studies. The drug companies exploit this.

Just look at how they always measure "risk" rather than incidence. Risk is a statistical measurement that greatly magnifies a small difference. The difference in the number of deaths per thousand might be one or two but the "risk" will go up 30%.

Even the data cited on the WebMD for statins cites only studies where it was shown to have effects in men with pre-existing heart disease.

But your doctor should be pointing YOU to the studies showing these drugs effective for people not diagnosed. The only one I could see that hinted in that direction cited found fewer heart attacks but the same number of cardiovascular deaths in a large group of people which included a lot of people with preexisting heart disease and diabetes.

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I was diagnosed with diabetes in 1998. Since then I've kept my A1cs in the 5.0-6.0% range using the techniques you'll find explained at The main Blood Sugar 101 Web Site, where you'll also find extensive discussion of the peer-reviewed research that backs up the statements you read here.

I've also published two books on related subjects, Blood Sugar 101: What They Don't Tell You About Diabetes, which was an Amazon Diabetes bestseller for 3 years and Diet 101: The Truth About Low Carb Diets.